Cruciate Ligaments of the Knee
Anterior Cruciate Ligament
The anterior cruciate ligament (ACL) in the knee prevents the tibia from sliding
upon the femur by acting like a tether or rein. Injury to the ACL usually results
from a twisting injury. Swelling, pain and instability in the knee generally
point to an ACL tear. A physician will assess the knee for the severity of
the sprain. X-rays are taken to rule out small associated fractures, and sometimes
an MRI (magnetic resonance imaging) is necessary to confirm ligamentous tears
and evaluate possible meniscal injury as well.
Treatment of partial ligament tears include a brief period
of rest (24-72 hours), the use of anti-inflammatory medication, compression
bandages, elevation and ice in an effort to reduce swelling. A gradual program
of quadriceps and hamstring strengthening is emphasized as well. A dedicated
physical rehabilitation program can be helpful for a return to full activity.
Patients with complete tears are evaluated for potential recovery
after nonsurgical treatment. Consideration is given to age, weight, activity
level and severity of the injury.
If surgery is selected by both the physician and the patient, a ligament is
reconstructed usually from the patient's own bone and tendon. Surgical intervention
is generally quite successful if undertaken in conjunction with a dedicated
physical therapy program. The reconstructed ligament itself takes up
to a year to fully heal, but a patient can gradually return to weight
bearing and athletic activity as he or she progresses through the rehabilitation
program.
Posterior Cruciate Ligament
The posterior cruciate ligament also extends from the tibia to the femur,
but in the back of the leg. It prevents the tibia from sliding backwards. Sprains
of this area tend to occur in tandem with other major injuries to the knee.
Posterior cruciate ligament(PCL) tears can be managed conservatively with a
program of physical therapy emphasizing the hamstring and quadriceps muscle
groups. With this injury, patients report a vague feeling of instability and
this injury is generally confirmed with an MRI (magnetic resonance image).
If surgical management of this injury becomes an option, a lengthy and dedicated
period of physical rehabilitation ensues, especially when other knee injuries
are involved. Most patients respond well to treatment, however, and can return
to an active life.
